Evergreen Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EVERGREEN OPTICAL

Practice address

3717 Union St
Suite 1
Flushing, NY 11354-5580

Phone

(718) 463-2500

NPI assigned

Sep 2, 2009

Last updated

Sep 2, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ok Ja Kim

Title

Owner

Phone

(718) 463-2500

Specialties & licenses 1

Addresses

Other names 1

• Hanmi Opticians Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1366675621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 UNION ST",
            "address_2": "SUITE 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545580",
            "telephone_number": "718-463-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 UNION ST",
            "address_2": "SUITE 1",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113545580",
            "telephone_number": "718-463-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "OK JA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-463-2500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hanmi Opticians",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.